ISBD webinar on COVID-19 22nd Jan 2021

On 22nd Jan. 2021 ISBD held a webinar on COVID-19, co-hosted by the Imperial Vascular Network and the Imperial Centre of Excellence for Vasculitis Research at Imperial College London. Speakers from across the world presented data on COVID and Behcet's from their country and this was followed by an audience participation discussion. Amongst topics discussed were whether BD provides protection or susceptibility to COVID, possible effects of drugs, potential mechanisms and issues relating to vaccination.

The programme was as follows: 

(click on links to see slides)

13.00 – Welcome and Introduction – Professors Dorian Haskard and Justin Mason, Imperial College, London.

13.05 – Purpose of the webinar – Dr Graham Wallace, University of Birmingham, UK

13.10 – Professor Phil Robinson, University of Queensland. Australia – COVID and Rheumatic Diseases

13.30  Short talks by: Professor Eun-So Lee, Ajou University, Korea; Professor Yohei Kirino, Yokohama City University Medical Center, Japan; Professor Farhad Shahram Tehran University of Medical Sciences, Iran; Professor Ahmet Gul, Istanbul Medical University, Turkey; Professor  Petros Sfikakis, National University of Athens, Greece; Professor Michael Schirmer, Medical University, Innsbruck, Austria.

14.30 -14.45 Break

14.45 -15.25  Short talks by: Professor Giacomo Emmi, University of Florence, Italy; Professor Christos Zouboulis, Dessau Medical Center, Germany; Professor Jan van Laar, Erasmus Medical Center, Rotterdam,  The Netherlands; Professor Farida Fortune, Queen Mary’s University of London, UK.

15.25-16.00 – General discussion – hosts Dr Graham Wallace and Professor Jan van Laar -to include do BD patients get COVID, how do they respond, are patients advised to shield, should BD patients be vaccinated.

Following the meeting, the following points have been collated by Professors Christos Zouboulis, Michael Schirmer and Jan van Laar. 

1. The prevalence of COVID-19 infection in patients with Adamantiades-Behçet's disease (ABD)* is apparently lower than that of the general population, and this may be due to ABD patients having been especially careful with social shielding. However, underestimation is also possible.
2. ABD appears to be not associated with a more severe course of COVID-19 infection.
3. Treatment of ABD with low-dose prednisolone (<10 mg/d) and/or biologics (esp. TNF-alpha inhibitors) does not increase the risk for COVID-19 infection or a more severe course.
4. Treatment initiation of ABD with high-dose prednisolone, cyclosporine A, methotrexate or rituximab should be avoided if possible during the pandemic through concern of increasing COVID disease severity.
5. ABD patients who already receive high-dose prednisolone, cyclosporine A, methotrexate or rituximab should practice social shielding.
6. We do not yet know what effect if any vaccination has on ABD (and vice versa). Benefits versus risks should be considered at an individual level.
7. Treatment with biologics appears to be compatible with SARS-CoV2 vaccination during ABD remission or low disease activity and should not be interrupted.
8. Treatment with biologics appears not to compromise SARS-CoV2 vaccination. It may be advisable not to vaccinate during a significant flare of ABD. Serological confirmation of successful vaccination by ELISAs is recommended.
9. National self-protection and hygiene measurements should be adhered to. Self-protection with masks is recommended even despite vaccination.

* The term Adamantiades-Behçet's disease is used in this account. For clarity, Adamantiades-Behçet's disease, Behçet's disease and Behçet's syndrome refer to the same condition.